I spoke with a colleague who specializes in developmental pediatrics, who expressed a lack of surprise at these numbers. They continue a trend that has already been demonstrated in numerous prior epidemiological studies, though the exact cause continues to elude us. This study doesn’t say anything about what’s actually causing these increases.
What this new report tells us is “how much” and “who.” Breaking down the numbers, we see that white children are more likely to carry an ASD diagnosis than black or Hispanic children, and that there is a great deal of variation throughout the country. (The study used data collected from 11 states to extrapolate rates for the US as a whole.) Boys are much more likely to be affected than girls, and nearly half of diagnosed patients had at least average intelligence.
As a pediatrician, the number that jumped out most to me is that only 44% of children with ASD diagnoses had a documented developmental evaluation by the time they reached 36 months of age. Though some ASD patients can present with very subtle findings early on, it worries me that 89% of them had documented concerns about their development by the same age. It seems that a large proportion of these patients are going too long without being evaluated even after problems are noted. Screening for delays in speech, motor, and social development during infant and toddler well-child checks is one of the most important things medical providers do, with the goal to get children into necessary therapies as promptly as possible. For many of these patients, it appears they didn’t get the attention and help they needed as early as they ought have.
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